云南省德宏州美沙酮维持治疗效果评价  

Evaluation of effectiveness of methadone maintenance treatment in Dehong prefecture of Yunnan

作　　者：项丽芬[1] 刘芃[2] 高洁[1] 杨跃诚[1] 叶润华[1] 段一娟[3] 李忠诚[3] 杨顺生[4] 官平珍[4] 龙玉存[5] 莫惠萍[5] 尹棉松[6] 李国强[7] 李升奇 庞琳[2] 刘恩武[2] 吴尊友[2] 段松[1] 

机构地区：[1]德宏州疾病预防控制中心,云南德宏678400 [2]中国疾病预防控制中心性病艾滋病预防控制中心,北京102206 [3]瑞丽市疾病预防控制中心,德宏678600 [4]潞西市疾病预防控制中心,云南德宏678400 [5]陇川县疾病预防控制中心,云南德宏678700 [6]梁河县疾病预防控制中心,云南德宏679200 [7]盈江县疾病预防控制中心,云南德宏679300

出　　处：《中国艾滋病性病》2011年第4期426-429,共4页Chinese Journal of Aids & STD

基　　金：中央艾滋病防治专项经费;艾滋病和病毒性肝炎等重大传染病防治科技重大专项(2008ZX10001-016)~~

摘　　要：目的评价社区美沙酮维持治疗降低吸毒人群艾滋病病毒（HIV）新发感染的效果。方法从国家＂艾滋病综合防治信息系统＂社区美沙酮维持治疗数据库下载德宏州数据,获得美沙酮服药人员动态队列HIV新发感染发病密度,与德宏州未参加美沙酮治疗的吸毒人群动态队列进行比较,评价美沙酮维持治疗预防HIV新发感染的效果。结果美沙酮服药人员队列入组1 050人,观察1 517.66人年,共发现14例HIV新发感染,4年平均发病密度为0.92/100人年,入组初期发病密度较高;德宏州未参加美沙酮治疗的吸毒人群队列入组708人,观察1 037.61人年,共发现47例新发感染,4年平均发病密度4.53/100人年,随访过程中发病密度均较高。美沙酮服药人员队列HIV新发感染的危险是德宏州吸毒人群队列的0.20倍（95%CI：0.11~0.36）。单纯口吸或烫吸、单纯注射或注射与其他方式混用的吸毒者中,美沙酮服药人员发生HIV新发感染的危险分别是德宏州吸毒人群的0.07倍和0.21倍。结论社区美沙酮维持治疗能够有效降低吸毒人群的HIV新发感染。Objective To evaluate the effectiveness of methadone maintenance treatment （MMT） in reducing HIV incidence. Methods A cohort data of Dehong methadone maintenance treatment was constructed by downloading data from the national HIV/AIDS information monitoring system of methadone maintenance treatment clinics. Incidence density was calculated and compared with that of drug users in the community to assess the effectiveness of MMT. Results The cohort of MMT enrolled 1050 subjects and observed 1517. 66 person-year and 14 HIV seroconversion occurred, with incidence density of 0.92/100 person-year; and the new incidence mainly occurred in the first 1.5 years. The cohort of drug users in the community enrolled 708 subjects and observed 1037.61 person-year, and 47 HIV sero-conversion occurred with incidence density of 4.53/100 person-year; the new incidence occurred with no regularity. Compared with the drug users in the community, the rate of HIV sero-conversion for drug users in MMT clinics was 0.20 （95;CI： 0.11--0. 36）. In simply oral/burning intake drug users and injection mixed drug users, the rate of HIV sero-conversion for drug users in MMT clinics in comparison with them in community was 0.07 and 0.21, respectively. Conclusion MMT is effective in reducing HIV transmission among drug users.

关 键 词：艾滋病 队列研究 美沙酮治疗 新发感染 效果评估 

分 类 号：R512.91[医药卫生—内科学]